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Approximate equivalent dose* (mg)
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Relative glucocorticoid activity
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Relative mineralocorticoid activity
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Duration of action (hours)
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General therapeutic indications
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|---|
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Glucocorticoids
|
|
Short-acting
| | | | | |
|
Hydrocortisone
|
20
|
1
|
1
|
8-12
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• Relatively high mineralocorticoid activity makes it suitable for use in adrenal insufficiency
|
|
Cortisone
|
25
|
0.8
|
0.8
|
8-12
|
• Similar to hydrocortisone
|
|
Intermediate-acting
| | | | | |
|
Prednisone
|
5
|
4
|
0.8
|
12-36
|
• High glucocorticoid activity makes it useful for long-term treatment, and as an anti-inflammatory/ immunosuppressant
|
|
Prednisolone
|
5
|
4
|
0.8
|
12-36
|
• Similar to prednisone
|
|
Methylprednisolone
|
4
|
5
|
Minimal
|
12-36
|
• Anti-inflammatory/immunosuppressant
|
|
Triamcinolone
|
4
|
5
|
0
|
12-36
|
• Anti-inflammatory/immunosuppressant
|
|
Long-acting
|
|
Dexamethasone
|
0.75
|
30
|
Minimal
|
36-72
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• Anti-inflammatory/immunosuppressant; used especially when water retention is undesirable given its minimal mineralocorticoid activity
|
|
• Usually reserved for short-term use in severe, acute conditions given its high potency and long-duration of action
|
|
Betamethasone
|
0.6
|
30
|
Negligible
|
36-72
|
• Similar to dexamethasone
|
|
Mineralocorticoids
|
|
Fludrocortisone
|
**
|
10-15
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125-150
|
12-36
|
• Used for aldosterone replacement
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- Table adapted from NICE, 2012 [1]; Furst et al., 2012 [8].
- *Equivalent dose shown is for oral or IV administration. Relative potency for intra-ocular or intramuscular administration may vary considerably.
- **Glucocorticoid doses which provide a mineralocorticoid effect that is approximately equivalent to 0.1 mg of fludrocortisone are: prednisone or prednisolone 50 mg, or hydrocortisone 20 mg.
